A couple of weeks ago, various leaders from the Department of Health and Human Services (HHS) testified in front of Congress about the government's response to COVID. One of those leaders was the Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky. A Congresswoman asked Walensky how evidence is processed to determine if the CDC updates, modifies, or withdraws current guidance. You can see Walkensy's response below. Ultimately, she says that "our masking guidance doesn't change with time." What can possibly be wrong with that statement?
When asked if the CDC will revise its guidance to mandate masks in schools in light of the Cochrane review showing masks do not curb COVID, CDC Director Walensky tells Congress its advice on child masking will never change. “Our masking guidance doesn’t really change with time.” pic.twitter.com/TwjZpN3jEl
— Michael P Senger (@MichaelPSenger) February 14, 2023
If you noticed, she made her comment in reference to the Cochrane systematic review. I covered the topic of the Cochrane systematic review a couple of weeks ago. The findings of this systematic review were that face masks do not work, and that included the lauded N95 masks. While she did acknowledge the Cochrane review, she also diminished it in whatever way she could.
For one, she said that the review only included randomized control trials (RCT). The RCT is considered the gold standard for public health interventions, so I am baffled as to why she would ignore that important detail. She complained that some of the RCTs were not for COVID. At the same time, there were 11 RCTs related to COVID. It is not as if the RCTs related to influenza-like illness were completely irrelevant. Then she says there were not enough studies in the meta-study or they were not robust enough. Who doesn't wish for more studies in a meta-study? She pointed out methodological flaws, as if all studies do not point out their methodological limits as a standard disclaimer. But as we shall see shortly, the Cochrane review is much less problematic than studies that the CDC has lauded as evidence.
And where does she get the chutzpah to complain there were not enough studies? She said in her testimony that the CDC did not conduct clinical trials because "there was not equipoise to the question." This is a fancy way of saying "it is so obvious that masks work that we did not bother conducting the studies." You cannot both shirk your responsibility to conduct clinical trials to see if the masks work and complain that there are not enough studies.
In May 2020, the CDC hailed "the latest science" from a single case study from a hair salon in Missouri. Amazing how the CDC was able to draw such a sweeping conclusion from such a small observational study. The CDC then jumped on another case study of schools in Arizona that was so methodologically flawed that the Left-leaning Atlantic called out the CDC on its usage of shaky science. One or two case studies are much lower on the hierarchy of public health evidence. Systematic reviews and meta-analyses of RTCs are the gold standard for public health research. The CDC has jumped on much weaker evidence to advocate for masks, which implies that the CDC cares more about staying face than it does what the Cochrane study had to say.
Walensky and other critics of the Cochrane review argue that the clinical trials conducted so far are not extensive enough to draw conclusions. While there is a theoretical possibility that further studies could show that masks could do some good, that is not where we are at right now. The argument they are making is trying to shift burden of proof onto the mask skeptics, not mask lovers. Change “face mask efficacy” with “Bigfoot.” The argument would sound like “we don’t have evidence of Bigfoot, but that doesn’t mean Bigfoot doesn’t exist.” Most people don’t use that logic to justify a position that Bigfoot exists, so why do mask lovers think they can get away with such flawed logic? The same argument would apply for Ivermectin and COVID. The issue is not absence of evidence, but rather evidence of absence.
The reality is that three years of a pandemic, the best available evidence, whether in the form of RCTs or observational studies, shows that face masks are ineffective at curtailing COVID transmission. If an intervention is not proven to work vis-à-vis RTCs, it has been common practice in the medical world to abandon it. We should advise the public on health practices based on the best evidence, not on the fantastical whims of the most risk-averse, fearful members of society.
If Walensky cared about scientific evidence or rigor, she would not base the CDC's recommendations off of some vague possibility that masks might work. She would follow the conclusions from the gold standard organization that conducted the systematic review of studies that are considered the gold standard of public health research. As the head author of the Cochrane review emphatically stated, "there is just no evidence that they [the face masks] make any difference. Full stop."
When Walensky said "our masking guidance really doesn't change with time," what Walensky is effectively saying is that she does not care what the best available scientific evidence has to say. She does not care whether public health advice is supposed to be made based on strong evidence. The CDC's job is to be "the nation's leading science-based, data-driven, service organization that protects the public health." If she is going to do her job, she should follow the most science-based solutions instead of her wishful thinking.
This is hardly Walensky's first faux pas as it relates to COVID. In November 2021, Walensky could not explain why the CDC did not conduct any clinical studies on natural immunity from COVID. Walensky greatly exaggerated the risk of transmitting COVID outdoors, as well as the threat of breakthrough cases. She recommended double masking by only using simulated data gathered in a laboratory instead of clinical data. She also said in July 2021 that there would not be a federal vaccine mandate, only for there to be one two months later. Not only did Walensky sign the John Snow Memorandum that advocated for the discredited lockdowns, but she lauded China's zero-COVID policy. That one aged really well!
In short, the CDC is not committed to the most readily available data or anything remotely related to the scientific method. Much like former NIAID Director Anthony Fauci, Walensky has shown that she is not interested in following best scientific practice. Walensky would rather cling onto public health practices that are not shown to be effective. Ladies and gentlemen, my advice in May 2021 rings as true as it did back then: we should ignore the CDC and simply enjoy our lives because the CDC is incapable of providing best evidence when it comes to public health.
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